Acute Kidney Injury before Dialysis Initiation Predicts Adverse Outcomes in Hemodialysis Patients

2018 ◽  
Vol 47 (6) ◽  
pp. 427-434 ◽  
Author(s):  
Timmy Lee ◽  
Silvi Shah ◽  
Anthony C. Leonard ◽  
Pratik Parikh ◽  
Charuhas V. Thakar
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
The United States ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Study Cohort ◽  
All Cause Mortality ◽  
Arteriovenous Access ◽  
The Impact ◽  
Esrd Patients

Background: Acute kidney injury (AKI) is associated with increased morbidity and mortality. Mortality in end-stage renal disease (ESRD) patients is highest during the first year of dialysis. The impact of pre-ESRD AKI events on long-term outcomes in incident ESRD patients remains unknown. Methods: We evaluated a retrospective cohort of 47,341 incident hemodialysis patients from the United States Renal Data System with linked Medicare data for at least 2 years prior to hemodialysis initiation. We examined the impact of pre-ESRD AKI events in the 2-year pre-ESRD period on the type of vascular access used at hemodialysis initiation (central venous catheter (CVC) versus arteriovenous access), and 1-year all-cause mortality after initiating hemodialysis. Results: The mean age was 72 ± 11 years. Of the study cohort, 18% initiated hemodialysis with arteriovenous access, and 54% of patients had at least one pre-ESRD AKI event. One-year, all-cause mortality was 32%. Compared to 75% for patients without a pre-ESRD AKI event, 89% of patients with a pre-ESRD AKI event initiated hemodialysis with CVC than arteriovenous access (p < 0.001). A pre-ESRD AKI event was associated with lower adjusted odds of starting hemodialysis with an arteriovenous access (OR 0.47; 95% CI 0.44–0.50, p < 0.001), and higher adjusted odds of 1-year mortality (OR 1.36; 95% CI 1.30–1.42, p < 0.001). Conclusion: An AKI event prior to initiating hemodialysis independently increases the risk of CVC use and predicts 1-year mortality. Improving processes of care after AKI events may improve dialysis outcomes in patients who progress to ESRD.

Multimodal Analgesia and Decreased Opioid Use in Adult Trauma Patients

2020 ◽  
Vol 86 (8) ◽  
pp. 950-954
Author(s):  
Andrew L. Drahos ◽  
Anthony M. Scott ◽  
Tracy J. Johns ◽  
Dennis W. Ashley
Keyword(s):  
Acute Kidney Injury ◽  
Management Strategies ◽  
Kidney Injury ◽  
Multimodal Analgesia ◽  
The United States ◽  
Control Group ◽  
Trauma Patients ◽  
Opioid Use ◽  
Trauma Service ◽  
The Impact

Background There is an opioid epidemic in the United States. With the increased concern of over-prescribing opioids, physicians are seeking alternative pain management strategies. The purpose of this study is to review the impact of instituting a multimodal analgesia (MMA) guideline on decreasing opioid use in trauma patients at a Level 1 trauma center. Methods In 2017, an MMA guideline was developed and included anti-inflammatories, muscle relaxants, neuropathic agents, and local analgesics in addition to opioids. Staff were educated and the guideline was implemented. A retrospective review of medications prescribed to patients admitted from 2016 through 2018 was performed. Patients admitted in 2016 served as the control group (before MMA). In 2018, all patients received multimodal pain therapy as standard practice, and served as the comparison group. Results A total of 10 340 patients were admitted to the trauma service from 2016 through 2018. There were 3013 and 3249 patients for review in 2016 and 2018, respectively. Total morphine milligram equivalents were 2 402 329 and 1 975 935 in 2016 and 2018, respectively, a 17.7% decrease ( P < .001). Concurrently, there was a statistically significant increase in the use of multimodal pain medications. A secondary endpoint was studied to evaluate for changes in acute kidney injury; there was not a statistically significant increase (0.56% versus 0.68%, P = .55). Discussion Implementation of an MMA guideline significantly reduced opioid use in trauma patients. The use of nonopioid MMA medications increased without an increased incidence of acute kidney injury.

Associations Between Predialysis Creatinine, SOFA Score, and Mortality in Acute Kidney Injury Patients Requiring Dialysis

2020 ◽  
Author(s):  
Hsin-Hsiung Chang ◽  
Chia-Lin Wu ◽  
Ping-Fang Chiu
Keyword(s):  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Creatinine Level ◽  
Sofa Score ◽  
External Validation ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Validation Dataset ◽  
Study Cohort ◽  
The Impact

Abstract Background: Creatinine is widely used to estimate renal function, but this is not practical in critical illness. Low creatinine has been associated with mortality in many clinical settings. However, the associations between predialysis creatinine level, Sepsis-related Organ Failure Assessment (SOFA) score, and mortality in acute kidney injury patients receiving dialysis therapy (AKI-D) has not been fully addressed. Methods: We extracted data for AKI-D patients in the eICU (n = 1,992) and MIMIC (n = 1,001) databases. We conducted a retrospective observational cohort study using the eICU dataset. The study cohort was divided into the high-creatine group and the low-creatinine group by the median value (4 mg/dL). The baseline patient information included demographic data, laboratory parameters, medications, and comorbid conditions. The independent association of creatinine level with mortality was examined using multivariate logistic regression analysis. We also carried out a sensitivity analysis using the MIMIC dataset.Results: In all 1,992 eICU participants, the 30-day intensive care unit mortality rate was 32.2%. The crude overall mortality rate in the low-creatinine group (43.7%) was significantly higher than that in the high-creatinine group (20.6%; P < 0.001). In the fully adjusted models, the high-creatinine group was associated with a lower risk of all-cause mortality (odds ratio, 0.56; 95% confidence interval, 0.42–0.75; P < 0.001) compared with the low-creatinine group. The nonrenal SOFA score was higher in the low-creatinine group. The results were consistent when the MIMIC dataset was used as an external validation dataset.Conclusions: AKI-D patients with a low predialysis creatinine value had a significantly higher risk of mortality that might be associated with more organ dysfunctions. Moreover, SOFA and nonrenal SOFA scores did not sufficiently reflect the severity of illness without considering the impact of the creatinine value in AKI-D patients.

P1531DIURETIC USE IN HEMODIALYSIS PATIENTS: BENEFIC ASSOCIATION WITH RESIDUAL RENAL FUNCTION AND ALL-CAUSE MORTALITY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maria do Sameiro Faria ◽  
Maria João Valente ◽  
Susana Rocha ◽  
Susana Coimbra ◽  
Cristina Catarino ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Function ◽  
Cystatin C ◽  
Serum Potassium ◽  
Inflammatory Markers ◽  
Residual Renal Function ◽  
Hemodialysis Patients ◽  
All Cause Mortality ◽  
The Impact ◽  
Esrd Patients

Abstract Background and Aims In patients with end-stage renal disease (ESRD) on hemodialysis, the preservation of residual kidney function may result in a diversity of benefits in terms of survival and quality of life. The control of fluid and electrolyte homeostasis may play an important role in this setting. Elevated predialysis serum potassium is a common electrolyte disturbance that may worsen patient’s outcomes. Our aim was to study the impact of furosemide therapy in predialysis serum potassium levels, indicators of estimated residual renal function, and inflammatory markers, in ESRD patients under hemodialysis; moreover, we aimed to study the impact of furosemide-associated changes on mortality rate. Method A cross-sectional study was carried out on 289 adult patients on chronic dialysis therapy (hemodiafiltration and high flux hemodialysis). Patients were divided in 2 groups: the diuretic group (DG, n=116; 120.0 (IQR: 80-160) mg/daily median furosemide dose) and the non-diuretic group (NDG, n = 173), in which patients did not use furosemide. A large set of data was analyzed, encompassing hematological data, serum electrolyte parameters, inflammatory markers, dialysis adequacy, and biomarkers of residual kidney function. A 2-year follow up study was also performed by registering events of death (all-cause mortality). Results The DG patients, compared with NDG patients, presented: significantly lower predialysis serum potassium; more favorable blood biomarkers of kidney function - lower β-trace protein, cystatin C, creatinine and urea; greater residual glomerular filtration rate derived from equations with cystatin C, creatinine and creatinine–cystatin C; lower inflammation (significantly lower levels of high-sensitivity C-reactive protein); intradialytic ultrafiltration volume (L) was similar for the two groups. Mortality was significantly lower for DG patients, compared with NDG (13.6% versus 24.7%; P=0.029). Conclusion In ESRD patients under chronic dialysis, we found a significant association between current diuretic therapy and lower predialysis serum potassium levels, more favorable biomarkers of kidney function and a decreased inflammatory response that seem to contribute to a higher survival rate. Acknowledgments: The work was supported by UIDB/04378/2020 with funding from FCT/MCTES through national funds, by North Portugal Regional Coordination and Development Commission (CCDR-N)/NORTE2020/Portugal 2020 (Norte-01-0145-FEDER-000024) and by REQUIMTE-Rede de Química e Tecnologia-Associação in the form of a researcher (S. Rocha) – project Dial4Life co-financed by FCT/MCTES (PTDC/MEC-CAR/31322/2017) and FEDER/COMPETE 2020 (POCI-01-0145-FEDER-031322).

scholarly journals Association between recovered acute kidney injury within 48hours and mortality in patients following coronary angiography: a cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Q Li ◽  
S Q Chen ◽  
H Z Huang ◽  
L W Liu ◽  
W H Chen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Odds Ratio ◽  
Baseline Level ◽  
Primary Outcome ◽  
Multivariable Analysis ◽  
Kidney Injury ◽  
Funding Sources ◽  
All Cause Mortality ◽  
The Impact

Abstract Background The association of recovered acute kidney injury (AKI) with mortality was controversial. Our study aims to investigate the impact of recovered AKI on mortality in patients following coronary angiography (CAG). Methods Our study retrospectively enrolled 3,970 patients with pre-operative serum p creatinine (Scr) and twice measurements within 48hours after procedure. Recovered AKI defined as the diagnosis of AKI (Scr &gt;0.3 mg/dL or &gt;50% from the baseline level) on day 1 when Scr failed to meet the criteria for AKI on the day 2. Maintained AKI was defined as AKI not meeting the definition for recovered AKI. The primary outcome was 1-year all-cause mortality. Multivariable logistic regression was used to assess the association between recovered AKI and 1-year mortality. Results Among 3,970 participants, 861 (21.7%) occurred AKI, of whom 128 (14.9%) was recovered AKI and 733 (85.1%) was maintained AKI. 312 (7.9%) patients died within 1-year after admission. After multivariable analysis, recovered AKI was not associated with higher 1-year mortality (adjusted odds ratio [aOR], 1.37; CI, 0.68–2.51) compared without AKI. Among AKI patients, Recovered AKI was associated with a 52% lower 1-year mortality compared with maintained AKI. Additionally, maintained AKI was significantly associated with higher 1-year mortality (aOR, 2.67; CI, 2.05–3.47). Conclusions Our data suggested that recovered AKI within 48h was a common subtype of AKI following CAG, without increasing mortality. More attention need to be paid to the patients suffering from maintained AKI following CAG. FUNDunding Acknowledgement Type of funding sources: None. Association of AKI and mortality Subgroups analysis

Acute Kidney Injury Defined by Fluid Corrected Creatinine in Neonates After the Norwood Procedure

2018 ◽  
Vol 9 (5) ◽  
pp. 513-521 ◽  
Author(s):  
Megan McFerson SooHoo ◽  
Sonali S. Patel ◽  
James Jaggers ◽  
Sarah Faubel ◽  
Katja M. Gist
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Retrospective Chart Review ◽  
Adverse Outcomes ◽  
Norwood Procedure ◽  
Multivariable Logistic Regression Analysis ◽  
Increased Risk ◽  
The Impact

Background: Both the Norwood procedure and acute kidney injury (AKI) are associated with significant morbidity and mortality. The impact of AKI by measured and fluid corrected serum creatinine on outcomes after the Norwood procedure has not been previously studied. The purpose of this study was to (1) identify the incidence of AKI, (2) determine AKI risk factors, and (3) evaluate outcomes in patients with AKI using both measured and fluid corrected serum creatinine. Methods: Single-center retrospective chart review from 2009 to 2015 including neonates who underwent the Norwood procedure. Acute kidney injury was defined by the Kidney Disease Improving Global Outcomes staging criteria using both measured and fluid corrected serum creatinine. Multivariable logistic regression analysis was performed to determine the risk factors associated with AKI. Results: Ninety-five neonates underwent the Norwood procedure. Correcting for fluid overload increased the incidence of AKI from 40% to 44%, increased AKI severity in 15 patients, and improved the identification of adverse outcomes associated with AKI. Patients palliated with the modified Blalock-Taussig shunt (mBTS) had a 9.4 greater odds of fluid corrected AKI compared to those palliated with a right ventricle to pulmonary artery conduit (95% confidence interval [95% CI]: 1.68-52.26, P = .01). A higher vasoactive inotrope score (VIS) on postoperative day (POD) 0 was associated with fluid corrected AKI (odds ratio: 1.20, 95% CI: 1.06-1.35; P = .003). Conclusions: Acute kidney injury is common after the Norwood procedure. Correcting creatinine for fluid balance revealed new cases of AKI. Use of an mBTS and higher VIS on POD 0 were associated with increased risk of AKI.

Effect of Acetaminophen on the Prevention of Acute Kidney Injury in Patients With Sepsis

2017 ◽  
Vol 52 (1) ◽  
pp. 48-53
Author(s):  
Asad E. Patanwala ◽  
Ohoud Aljuhani ◽  
Hussain Bakhsh ◽  
Brian L. Erstad
Keyword(s):  
Acute Kidney Injury ◽  
Primary Outcome ◽  
Kidney Injury ◽  
The United States ◽  
Primary Outcome Measure ◽  
Academic Medical Centers ◽  
Study Cohort ◽  
Medical Centers ◽  
Academic Medical ◽  
Inhibit Lipid Peroxidation

Background: Acute kidney injury (AKI) commonly occurs in patients with sepsis. Acetaminophen (APAP) has been shown to inhibit lipid peroxidation and, thus, may be renal protective in patients with sepsis. Objective: The objective of this study was to determine the effect of APAP on AKI in patients with sepsis. Methods: This was a retrospective cohort study conducted at 2 affiliated academic medical centers in the United States. Adult patients who were admitted to the intensive care unit with a diagnosis of severe sepsis were included. Patients were categorized based on whether APAP was received within the first 7 days of hospitalization (APAP or no APAP groups). The primary outcome measure was occurrence or increase in AKI stage from admission. Multivariate logistic regression analyses were used to adjust for potential confounders. Results: There were 238 patients who were included in the study cohort. Of these, 122 received APAP and 116 did not receive APAP. AKI or exacerbation occurred in 16.4% (n = 20) of patients in the APAP group and 19.8% (n = 23) of patients in the no APAP group ( P = 0.505). After adjusting for the most important confounders, there was no significant association between APAP use and AKI (odds ratio = 1.2; 95% CI = 0.6-2.4; P = 0.639). Conclusion: APAP use in critically ill patients with sepsis may not reduce the occurrence or exacerbation of AKI.

Challenges Associated with Managing a Multicenter Clinical Trial in Severe Burns

2020 ◽  
Vol 41 (3) ◽  
pp. 681-689
Author(s):  
Elsa C Coates ◽  
Elizabeth A Mann-Salinas ◽  
Nicole W Caldwell ◽  
Kevin K Chung
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
High Volume ◽  
The United States ◽  
Data Safety Monitoring Board ◽  
Institutional Review Boards ◽  
Severe Burns ◽  
High Volume Hemofiltration ◽  
The Impact

Abstract Managing multicenter clinical trials (MCTs) is demanding and complex. The Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) trial was a prospective, MCT involving the impact of high-volume hemofiltration continuous renal replacement therapy on patients experiencing acute kidney injury and septic shock. Ten clinical burn centers from across the United States were recruited to enroll a target sample size of 120 subjects. This manuscripts reviews some of the obstacles and knowledge gained while coordinating the RESCUE trial. The first subject was enrolled in February 2012, 22 months after initial IRB approval and 29 months from the time the grant was awarded. The RESCUE team consisted of personnel at each site, including the lead site, a data coordination center, data safety monitoring board, steering committees, and the sponsor. Seven clinical sites had enrolled 37 subjects when enrollment stopped in February 2016. Obstacles included changes in institutional review boards, multiple layers of review, staffing changes, creation and amendment of study documents and procedures, and finalization of contracts. Successful completion of a MCT requires a highly functional research team with sufficient patient population, expertise, and research infrastructure. Additionally, realistic timelines must be established with strategies to overcome challenges. Inevitable obstacles should be discussed in the pretrial phase and continuous correspondence must be maintained with all relevant research parties throughout all phases of study.

scholarly journals Outcomes and factors leading to graft failure in kidney transplants from deceased donors with acute kidney injury—A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0254115
Author(s):  
Cheol Woong Jung ◽  
Dana Jorgensen ◽  
Puneet Sood ◽  
Rajil Mehta ◽  
Michele Molinari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Graft Failure ◽  
Graft Function ◽  
Kidney Injury ◽  
The United States ◽  
Kidney Transplants ◽  
Ischemic Time ◽  
Cold Ischemic Time ◽  
The Impact

Due to shortage of donor, kidney transplants (KTs) from donors with acute kidney injury (AKI) are expanding. Although previous studies comparing clinical outcomes between AKI and non-AKI donors in KTs have shown comparable results, data on high-volume analysis of KTs outcomes with AKI donors are limited. This study aimed to analyze the selection trends of AKI donors and investigate the impact of AKI on graft failure using the United states cohort data. We analyzed a total 52,757 KTs collected in the Scientific Registry of Transplant Recipient (SRTR) from 2010 to 2015. The sample included 4,962 (9.4%) cases of KTs with AKI donors (creatinine ≥ 2 mg/dL). Clinical characteristics of AKI and non-AKI donors were analyzed and outcomes of both groups were compared. We also analyzed risk factors for graft failure in AKI donor KTs. Although the incidence of delayed graft function was higher in recipients of AKI donors compared to non-AKI donors, graft and patient survival were not significantly different between the two groups. We found donor hypertension, cold ischemic time, the proportion of African American donors, and high KDPI were risk factors for graft failure in AKI donor KTs. KTs from deceased donor with AKI showed comparable outcomes. Thus, donors with AKI need to be considered more actively to expand donor pool. Caution is still needed when donors have additional risk factors of graft failure.

scholarly journals Urine Alpha-1-Microglobulin Levels and Acute Kidney Injury, Mortality, and Cardiovascular Events following Cardiac Surgery

2021 ◽  
pp. 1-11
Author(s):  
Jonathan G. Amatruda ◽  
Michelle M. Estrella ◽  
Amit X. Garg ◽  
Heather Thiessen-Philbrook ◽  
Eric McArthur ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Proportional Hazards ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Ckd Progression ◽  
Urine Albumin ◽  
All Cause Mortality

<b><i>Introduction:</i></b> Urine alpha-1-microglobulin (Uα1m) elevations signal proximal tubule dysfunction. In ambulatory settings, higher Uα1m is associated with acute kidney injury (AKI), progressive chronic kidney disease (CKD), cardiovascular (CV) events, and mortality. We investigated the associations of pre- and postoperative Uα1m concentrations with adverse outcomes after cardiac surgery. <b><i>Methods:</i></b> In 1,464 adults undergoing cardiac surgery in the prospective multicenter Translational Research Investigating Biomarker Endpoints for Acute Kidney Injury (TRIBE-AKI) cohort, we measured the pre-and postoperative Uα1m concentrations and calculated the changes from pre- to postoperative concentrations. Outcomes were postoperative AKI during index hospitalization and longitudinal risks for CKD incidence and progression, CV events, and all-cause mortality after discharge. We analyzed Uα1m continuously and categorically by tertiles using multivariable logistic regression and Cox proportional hazards regression adjusted for demographics, surgery characteristics, comorbidities, baseline estimated glomerular filtration rate, urine albumin, and urine creatinine. <b><i>Results:</i></b> There were 230 AKI events during cardiac surgery hospitalization; during median 6.7 years of follow-up, there were 212 cases of incident CKD, 54 cases of CKD progression, 269 CV events, and 459 deaths. Each 2-fold higher concentration of preoperative Uα1m was independently associated with AKI (adjusted odds ratio [aOR] = 1.36, 95% confidence interval 1.14–1.62), CKD progression (adjusted hazard ratio [aHR] = 1.46, 1.04–2.05), and all-cause mortality (aHR = 1.19, 1.06–1.33) but not with incident CKD (aHR = 1.21, 0.96–1.51) or CV events (aHR = 1.01, 0.86–1.19). Postoperative Uα1m was not associated with AKI (aOR per 2-fold higher = 1.07, 0.93–1.22), CKD incidence (aHR = 0.90, 0.79–1.03) or progression (aHR = 0.79, 0.56–1.11), CV events (aHR = 1.06, 0.94–1.19), and mortality (aHR = 1.01, 0.92–1.11). <b><i>Conclusion:</i></b> Preoperative Uα1m concentrations may identify patients at high risk of AKI and other adverse events after cardiac surgery, but postoperative Uα1m concentrations do not appear to be informative.

scholarly journals 363. Acute Kidney Injury and Renal Replacement Therapy in Hospitalized COVID-19 Patients in the United States and Other Geographic Regions

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S251-S251
Author(s):  
Shannon NovosadShannon NovosadLeah Gilbert ◽  
Ibironke W Apata ◽  
Rahsaan Overton ◽  
Shikha Garg ◽  
Lindsey Kim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Resource Planning ◽  
The United States ◽  
Icu Patients ◽  
The Us ◽  
The Impact

Abstract Background Acute kidney injury (AKI) is a complication that has been described among severely ill patients with COVID-19 and may be more common in those with underlying chronic kidney disease (CKD). Some patients with AKI require renal replacement therapy (RRT), including continuous RRT (CRRT). During the COVID-19 pandemic, some US areas experienced CRRT supply shortages. We sought to describe the percent of hospitalized COVID-19 patients who developed AKI or needed RRT to inform patient care and resource planning. Methods We searched for studies in the literature and public health investigations that described CKD, AKI, and/or RRT in COVID-19 patients from January 2020 onward. Studies were excluded if no CKD, AKI, or RRT information was provided. We abstracted counts of hospitalized COVID-19 patients, including those admitted to intensive care units (ICU) who developed AKI, underwent RRT, and/or had CKD. Data were pooled across cohorts by geographic region with available data (US, China, or United Kingdom [UK]). We compared proportions using Chi-square tests. Results A total of 311 studies were identified; 23 studies (US n=11; China n=11; UK n=1) that described kidney disease and/or kidney-related outcomes in hospitalized COVID-19 patients were included. Underlying CKD prevalence was higher in US cohorts (10.3%) compared with China (2.5%) or UK (1.5%) (p&lt; 0.0001). AKI was markedly higher among hospitalized (31.3% vs. 6.4%; p &lt; 0 .001) and ICU patients (55.4% vs. 18.2%; p&lt; 0.0001) in the US compared to China. The percent of ICU patients requiring RRT in the US (16.8%) was significantly different from that reported in China (12.5%) and the UK (23.9%) (p&lt; 0.0001). Limitations include differences in CKD and RRT definitions across studies. Conclusion AKI is a frequent outcome among US COVID-19 patients, affecting almost one third of hospitalized and more than half of ICU patients. AKI was reported more frequently in the US than China. The percent of ICU patients who received RRT was higher in the US and UK than in China. Understanding the occurrence of kidney-related outcomes among patients with COVID-19 including the impact of underlying CKD and regional practice variations is essential for healthcare systems to successfully plan for RRT needs during the pandemic. Disclosures All Authors: No reported disclosures

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